JENNIFER BLEAK MD Medical Doctor License verification

JENNIFER BLEAK MD

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036083757

License Status

ACTIVE

Business

First Name

JENNIFER

Last Name

BLEAK

Suffix

Business Name

JENNIFER BLEAK MD

Original Issue Date

11/19/1991

Effective Date

06/01/2023

Expiration Date

07/31/2026

City

JANESVILLE

State

Zip

53545

Ever Disciplined

LastModifiedDate

03/21/2025

Case Number

2025002357

Action

Surrender (Relinquish)

Discipline Start Date

03/19/2025

Discipline Reason

physician and surgeon license placed on indefinite surrender status due to her Wisconsin medical license being indefinitely suspended in February 2025 for history of ETOH impairment.